Original Article The Relationship between Non-Dipper Blood Pressure and Thoracic Aortic Diameter in Metabolic Syndrome

Objective: Non-dipper hypertension is associated with increased cardiovascular morbidity and mortality. The purpose of this study was to evaluate the association of non-dipping hypertension with aortic diameter in patients with metabolic syndrome. Materials and Methods: This study included 70 hypertensive patients with metabolic syndrome. These patients were evaluated with 24-h blood pressure Holter monitoring and divided into two groups of 35 patients each. Aortic diameter was measured by M-mode and two-dimensional echocardiography. These parameters were compared between the two groups. Results: In the dipper group, there were 26 female and 9 male patients with a mean age of 55±11 years. In the non-dipper group, there were 25 female and 10 male patients with a mean age of 56±11 years. No significant difference was found between the two groups in terms of basic characteristics. Non-dipper hypertensive patients had a higher thoracic aortic diameter value than dipper patients (35.6±2.4 and 33.23±1.1, p<0.01). Conclusion: These findings suggest that thoracic aortic diameter value is higher in patients with non-dipper hypertension. Key Words: Blood pressure, metabolic syndrome, aortic diameter, echocardiography, non-dippe

Neutrophil to lymphocyte ratio is associated with proximal/middle segment of the LAD lesions in patients with ST segment elevation infarction

Introduction: Neutrophil to lymphocyte ratio (NLR) was revaled to have a close relation with atherosclerotic cardiovascular disease. The relationship between NLR and culprit plaque localization has never been studied. Aim of the study : To evaluate the association between NLR and unstable plaque localization of left anterior descending artery (LAD) in anterior miyocardial infarction patients. Material and methods : Patients admitted to our hospital with acute anterior STEMI were included. Fifhy-eight patients who have single-vessel disease at LAD and their hematological parameters were analyzed retrospectively. Proximal segment of LAD lesions were groupped as Group I and mid segment of the LAD lesion groupped as Group II. The groups were compared according to their NLR and other parameters. Results : Between group I (n = 41, mean age 52.5 ±12.7) and group II (n = 17, mean ages 52.0 ±10.8); NLR, were significantly higher in group I compared to the group II (6.9 ±5.6 vs. 3.3 ±2.0, p = 0.01). In group I, left ventricular ejection fraction (LVEF) was significantly lower (p = 0.02). In correlation analyzes, NLR was positively correlated with CK MB (r = 0.32, p = 0.01) and negatively correlated with LVEF (r = –0.28, p = 0.03). Conclusions : The present study demonstrated that anterior myocardial infarction patients with high NLR had a greater possibility having proximal culprit lesion on the LAD. Therefore NLR can be used as a useful tool to culprit plaque localization in patients with acute miyocardial infarction patients

Função Atrial Esquerda Prejudicada Associada com a Fibrilação Atrial Paroxística na Hipertensão

Fundamento: A hipertensão arterial é o fator de risco mais prevalente e modificável para a fibrilação atrial. A sobrecarga de pressão no átrio esquerdo induz alterações fisiopatológicas que ocasionam alterações na função contrátil e nas propriedades elétricas. Objetivo: Nesse estudo, o objetivo foi avaliar a função do átrio esquerdo em pacientes hipertensos para determinar a associação entre a função atrial esquerda e a fibrilação atrial paroxística (FAP). Método: Foram estudados 57 pacientes hipertensos (idade: 53 ± 4 anos, fração de ejeção do ventrículo esquerdo: 76 ± 6,7%), incluindo 30 pacientes consecutivos com FAP e 30 indivíduos de controle pareados por idade. Os volumes do átrio esquerdo (AE) foram medidos através do método biplano de Simpson modificado. Foram determinados três tipos de volume do AE: volume máximo do AE (AEVmax), contração atrial prematura do AE (AEVpreA) e volume mínimo do AE (AEVmin). Foram calculadas as funções de esvaziamento do AE. Volume total de esvaziamento do AE = AEVmax - AEVmin e a FEtotal do AE = (AEVmax - AEVmin)/AEVmax, volume de esvaziamento passivo do AE = AEVmax-AEVpreA, e a FE do AE = (AEVmax - AEVpreA)/AEVmax, o volume de esvaziamento ativo do AE = AEVpreA- AEVmin e a FE ativa do AE = (AEVpreA - AEVmin)/AEVpreA. Resultados: O período hipertenso é maior no grupo de hipertensos com FAP. O AEVmax aumentou significativamente no grupo de hipertensos com FAP quando comparado ao grupo de hipertensos sem FAP (p = 0,010). A FEAE diminuiu significativamente no grupo de hipertensos com FAP em comparação com o grupo de hipertensos sem FAP (p = 0,020). A' diminuiu no grupo de hipertensos com FAP quando comparado com hipertensos sem FAP (p = 0,044). Conclusão: O volume aumentado do AE e função de esvaziamento ativa do AE prejudicada foram associados com a FAP em pacientes hipertensos não tratados. Um período hipertenso mais longo está associado com a FAP